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FIRE DAI4P.GE REPORT
OR
ELECTRICAL HAZARD
TO:
FR0t'1:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
DATE:-9'?5
,s 7$ >+Address or 'location of building
Name of or.,ner fr I t..*Mc-D *tt-
Type of building ui-g
(Dwel 'l i ng , S tc. ), Idarehou ,e
8a c>o OEstimated value of building
Es timated I oss to bu i 'ld i ng $5ao
Date of fire )-9.?5
Location of damage in bui'lding g a-q qe c,lc-t I
Roof , l,'lal I , Exterior, Interior, etc. )
Structura'l weakness as a resu'lt of the fire Vtov--e
(Burned rafters, Beams, .1oists, etc.)
Addi tional pertinent information
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(l,li ri nq , 0ut'lets , etc. )
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